Intravenous versus oral etoposide: efficacy and correlation to clinical outcome in patients with high-grade metastatic gastroenteropancreatic neuroendocrine neoplasms (WHO G3)

Abir Salwa Ali; Malin Grönberg; Seppo W Langer; Morten Ladekarl; Geir Olav Hjortland; Lene Weber Vestermark; Pia Österlund; Staffan Welin; Henning Grønbæk; Ulrich Knigge; Halfdan Sorbye; Eva Tiensuu Janson

doi:10.1007/s12032-018-1103-x

Intravenous versus oral etoposide: efficacy and correlation to clinical outcome in patients with high-grade metastatic gastroenteropancreatic neuroendocrine neoplasms (WHO G3)

Abir Salwa Ali, Malin Grönberg, Seppo W Langer, Morten Ladekarl, Geir Olav Hjortland, Lene Weber Vestermark, Pia Österlund, Staffan Welin, Henning Grønbæk, Ulrich Knigge, Halfdan Sorbye, Eva Tiensuu Janson

Department of Clinical Medicine

6 Citations (Scopus)

23 Downloads (Pure)

Abstract

High-grade gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs, G3) are aggressive cancers of the digestive system with poor prognosis and survival. Platinum-based chemotherapy (cisplatin/carboplatin + etoposide) is considered the first-line palliative treatment. Etoposide is frequently administered intravenously; however, oral etoposide may be used as an alternative. Concerns for oral etoposide include decreased bioavailability, inter- and intra-patient variability and patient compliance. We aimed to evaluate possible differences in progression-free survival (PFS) and overall survival (OS) in patients treated with oral etoposide compared to etoposide given as infusion. Patients (n = 236) from the Nordic NEC study were divided into three groups receiving etoposide as a long infusion (24 h, n = 170), short infusion (≤ 5 h, n = 33) or oral etoposide (n = 33) according to hospital tradition. PFS and OS were analyzed with Kaplan-Meier (log-rank), cox proportional hazard ratios and confidence intervals. No statistical differences were observed in PFS or OS when comparing patients receiving long infusion (median PFS 3.8 months, median OS 14.5 months), short infusion (PFS 5.6 months, OS 11.0 months) or oral etoposide (PFS 5.4 months, OS 11.3 months). We observed equal efficacy for the three administration routes suggesting oral etoposide may be safe and efficient in treating high-grade GEP-NEN, G3 patients scheduled for cisplatin/carboplatin + etoposide therapy.

Original language	English
Article number	47
Journal	Medical Oncology
Volume	35
Issue number	4
Pages (from-to)	1-7
Number of pages	7
ISSN	1357-0560
DOIs	https://doi.org/10.1007/s12032-018-1103-x
Publication status	Published - 1 Apr 2018

Keywords

Administration, Oral
Adult
Aged
Aged, 80 and over
Antineoplastic Agents, Phytogenic/administration & dosage
Disease-Free Survival
Etoposide/administration & dosage
Female
Humans
Infusions, Intravenous
Intestinal Neoplasms/drug therapy
Kaplan-Meier Estimate
Male
Middle Aged
Neuroendocrine Tumors/drug therapy
Pancreatic Neoplasms/drug therapy
Proportional Hazards Models
Retrospective Studies
Stomach Neoplasms/drug therapy
Treatment Outcome

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Ali, A. S., Grönberg, M., Langer, S. W., Ladekarl, M., Hjortland, G. O., Vestermark, L. W., Österlund, P., Welin, S., Grønbæk, H., Knigge, U., Sorbye, H., & Janson, E. T. (2018). Intravenous versus oral etoposide: efficacy and correlation to clinical outcome in patients with high-grade metastatic gastroenteropancreatic neuroendocrine neoplasms (WHO G3). Medical Oncology, 35(4), 1-7. [47]. https://doi.org/10.1007/s12032-018-1103-x

Intravenous versus oral etoposide : efficacy and correlation to clinical outcome in patients with high-grade metastatic gastroenteropancreatic neuroendocrine neoplasms (WHO G3). / Ali, Abir Salwa; Grönberg, Malin; Langer, Seppo W et al.

In: Medical Oncology, Vol. 35, No. 4, 47, 01.04.2018, p. 1-7.

Research output: Contribution to journal › Journal article › Research › peer-review

Ali, AS, Grönberg, M, Langer, SW, Ladekarl, M, Hjortland, GO, Vestermark, LW, Österlund, P, Welin, S, Grønbæk, H, Knigge, U, Sorbye, H & Janson, ET 2018, 'Intravenous versus oral etoposide: efficacy and correlation to clinical outcome in patients with high-grade metastatic gastroenteropancreatic neuroendocrine neoplasms (WHO G3)', Medical Oncology, vol. 35, no. 4, 47, pp. 1-7. https://doi.org/10.1007/s12032-018-1103-x

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abstract = "High-grade gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs, G3) are aggressive cancers of the digestive system with poor prognosis and survival. Platinum-based chemotherapy (cisplatin/carboplatin + etoposide) is considered the first-line palliative treatment. Etoposide is frequently administered intravenously; however, oral etoposide may be used as an alternative. Concerns for oral etoposide include decreased bioavailability, inter- and intra-patient variability and patient compliance. We aimed to evaluate possible differences in progression-free survival (PFS) and overall survival (OS) in patients treated with oral etoposide compared to etoposide given as infusion. Patients (n = 236) from the Nordic NEC study were divided into three groups receiving etoposide as a long infusion (24 h, n = 170), short infusion (≤ 5 h, n = 33) or oral etoposide (n = 33) according to hospital tradition. PFS and OS were analyzed with Kaplan-Meier (log-rank), cox proportional hazard ratios and confidence intervals. No statistical differences were observed in PFS or OS when comparing patients receiving long infusion (median PFS 3.8 months, median OS 14.5 months), short infusion (PFS 5.6 months, OS 11.0 months) or oral etoposide (PFS 5.4 months, OS 11.3 months). We observed equal efficacy for the three administration routes suggesting oral etoposide may be safe and efficient in treating high-grade GEP-NEN, G3 patients scheduled for cisplatin/carboplatin + etoposide therapy.",

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AU - Grönberg, Malin

AU - Langer, Seppo W

AU - Ladekarl, Morten

AU - Hjortland, Geir Olav

AU - Vestermark, Lene Weber

AU - Österlund, Pia

AU - Welin, Staffan

AU - Grønbæk, Henning

AU - Knigge, Ulrich

AU - Sorbye, Halfdan

AU - Janson, Eva Tiensuu

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KW - Middle Aged

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KW - Pancreatic Neoplasms/drug therapy

KW - Proportional Hazards Models

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KW - Stomach Neoplasms/drug therapy

KW - Treatment Outcome

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DO - 10.1007/s12032-018-1103-x

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SN - 1357-0560

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SP - 1

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JO - Medical Oncology

JF - Medical Oncology

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M1 - 47

ER -

Intravenous versus oral etoposide: efficacy and correlation to clinical outcome in patients with high-grade metastatic gastroenteropancreatic neuroendocrine neoplasms (WHO G3)

Abstract

Keywords

UN SDGs

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